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Diabetes and kidney cancer risk among post-menopausal women: The Iowa women’s health study

  • Shuo Wang
    Affiliations
    Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, United States
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  • Mark D. Lo Galbo
    Affiliations
    Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, United States

    Children’s Minnesota, Minneapolis, MN, United States
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  • Cindy Blair
    Affiliations
    Department of Internal Medicine, University of New Mexico, United States

    University of New Mexico Comprehensive Cancer Center, United States
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  • Bharat Thyagarajan
    Affiliations
    Masonic Cancer Center, University of Minnesota, United States

    Department of Laboratory Medicine and Pathology, Medical School, University of Minnesota, United States
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  • Kristin E. Anderson
    Affiliations
    Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, United States

    Masonic Cancer Center, University of Minnesota, United States
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  • DeAnn Lazovich
    Affiliations
    Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, United States

    Masonic Cancer Center, University of Minnesota, United States
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  • Anna Prizment
    Correspondence
    Corresponding author at: Division of Hematology, Oncology and Transplantation, University of Minnesota Medical School, Minneapolis, MN, United States.
    Affiliations
    Masonic Cancer Center, University of Minnesota, United States

    Division of Hematology, Oncology and Transplantation, Medical School, University of Minnesota, United States
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      Highlights

      • Diabetes is a risk factor for kidney cancer among non-obese post-menopausal women.
      • Time-dependent diabetes is associated with kidney cancer risk among post-menopausal women with a BMI < 30 kg/m2.
      • Time-dependent diabetes is associated with kidney cancer risk among post-menopausal women with a waist circumference <34.6 in..

      Abstract

      Background

      Many studies have reported a positive association between diabetes and kidney cancer. However, it is unclear whether diabetes is a risk factor for kidney cancer independent of other risk factors, such as obesity and hypertension. We comprehensively examined the association of diabetes and its duration with incident kidney cancer in the prospective cohort Iowa Women’s Health Study (1986–2011).

      Methods

      Diabetes status was self-reported at baseline (1986) and on five follow-up questionnaires. Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of baseline and time-dependent diabetes with the risk of incident kidney cancer.

      Results

      During the 25 years of follow-up, 245 cases of kidney cancer occurred among 36,975 post-menopausal women. In an age-adjusted model, there was a significant association between time-dependent diabetes and the risk of kidney cancer [HR (95% CI) = 1.76 (1.26, 1.45)]; the association was attenuated after multivariable adjustment for age, body mass index (BMI), waist-to-hip ratio (WHR), hypertension, physical activity, diuretic use, pack-years of smoking, alcohol intake, and total caloric intake [HR = 1.35 (0.94, 1.94)]. However, among non-obese women or women with a waist circumference less than 34.6 in., diabetes was significantly associated with kidney cancer risk: for time-dependent diabetes, HRs (95% CIs) were 1.82 (1.10, 3.00) among those with BMI < 30 kg/m2 and 2.18 (1.08, 4.38) among those with a waist circumference <34.6 in..

      Conclusions

      Our results suggest that diabetes is associated with kidney cancer risk among non-obese post-menopausal women.

      Keywords

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